Note: The job is a remote job and is open to candidates in USA. Intermountain Health is a healthcare organization seeking a Reimbursement Specialist Cash Control Analyst to manage cash reconciliation and variance reporting. The role involves evaluating payment variances, conducting root cause analysis, and collaborating with internal and external teams to improve reimbursement processes.
Responsibilities
- Evaluate payment variances in Epic WQs against payer contracts to determine if payer underpaid or overpaid, and dispositions variance based upon established protocols
- Identify trends through reporting and data analysis and leverages data to resolve errors in Epic proration rules, payer under and/or overpayment trends, opportunities in billing, and opportunities with managed care contracting efforts
- Log findings and provides feedback to Hospital Billing AR Management, Cash Management, and Managed Care leadership
- Perform root cause analysis and recommend and develop process improvement
- Serve as a liaison to internal teams to include the Epic Contract Maintenance Committee and to external payment variance vendors to leverage contract terms and mitigate revenue leakage and denials
- Help design and implement improvements to established or proposed reimbursement process flows to maximize potential revenue
- Work with Managed Care to ensure knowledge and interpretation of managed care contracts are aligned with original intent of health system contracting efforts
- Work with Compliance, Finance and Government insurance follow up teams to stay abreast of legislative changes impacting revenue and driving payment variances
- Initiate contact with technical teams to work through technical builds and enhancements for the Payment Variance team
- Participate and lead special projects, as assigned. Oversee workflow implementation with internal and external partners. Compile and coordinate materials and feedback on special projects. Trains and mentors' new associates to the department. Serves as a subject matter expert and resource to answer questions within the department
Skills
- High School Diploma or Equivalent, required
- Three (3) years of experience in revenue cycle insurance follow up or denial management, required
- Associate's degree, preferred
- Three (3) years of work experience in a complex invoice/billing/reconciliation environment, preferred
- Extensive knowledge of managed care contract interpretation
Benefits
- We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
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